Mindfulness courses reduce stress among doctors, nurses — lead to more compassionate patient care
Photo courtesy of the U.Va. mindfulness center
|The U.Va. Mindfulness Center teaches the technique of “mindfulness,” which it defines as a moment-to-moment, nonjudgemental awareness. The most basic mindfulness practice is available to anyone at any time, any place — sitting comfortably and concentrating on breathing. This helps clear your mind so you can make better choices when dealing with people and situations.
By Anne Bromley
An elderly patient was dying and further treatment would not have helped him. His doctor, Julia Connelly, braced herself and headed to his hospital room, prepared to tell the man and his wife that it was time for him to move to a nursing home. The conversation, however, did not end as she had expected.
The wife, fearing her husband might not survive the move, thought it would be better to wait until their children were able to visit their father in the hospital before moving him. Connelly, a U.Va. doctor with the Department of Internal Medicine, listened and consented. After the man saw his children, he was transported to the nursing home and died shortly thereafter.
Listening to her patients — really paying attention to them as people — led to a more compassionate exchange and positive experience, Connelly said. Having practiced mindfulness meditation for about 12 years now, she credits it with helping her care for patients better.
Medical personnel often are people who strive to help or fix everything, Connelly said. But many patients can’t be easily ‘fixed.’ Death is a constant reality. Primary care doctors often see patients with chronic conditions or those who have health issues because of psychological or economic problems. Doctors and nurses can be very critical of themselves, adding more stress to an already stressful situation and leading to burnout.
“Patients need health care professionals to be well enough themselves to be in a healing space,” said Dr. Matthew Goodman, who teaches mindfulness at the U.Va. Mindfulness Center, where teaching is in addition to his clinical work.
The U.Va. Mindfulness Center is part of the Department of Family Medicine at the U.Va. Health System. Co-directed by social worker Allie Rudolph and Dr. Matt Goodman, the center first began offering courses in mindfulness-based stress reduction in 1995. The center was able to further expand its current offerings beginning in 2000 thanks to substantial support from the John W. Kluge Foundation on behalf of Maria “Tussi” Kluge.
The Mindfulness Center’s courses, each lasting eight weeks, are modeled directly on those created and popularized by Jon Kabat-Zinn and offered through the University of Massachusetts Medical Center. The U.Va. center offers courses to the general public, to medical students and to health care professionals, which are becoming increasingly popular, Goodman said.
“If we’re rushed, stressed and overworked, it’s hard to connect with patients with compassion and empathy,” Goodman said. “We can retain our technical skills, but the compassion goes.”
“With the explosion of biomedical knowledge from the mid-20th century, that aspect of the doctor-patient connection has received less emphasis,” Goodman said. Studies have shown that patients are less satisfied with their doctors, even as they spend more and more on health care.
Connelly’s example illustrates what can happen when one follows the technique of “mindfulness,” which the Mindfulness Center defines as “moment-to-moment, nonjudgmental awareness. It is an age-old practice that enhances conscious relaxation, inner calm and peace, clear thinking and awareness of choices.” Most, if not all, religions include it as a spiritual method, but it doesn’t have to have a religious component,
according to practitioners.
The most basic mindfulness practice is available to anyone at any time, any place — sitting comfortably and concentrating on breathing. As you breathe in and out, notice the thoughts and feelings crowding your mind. They affect your daily life, whether or not you’re conscious of them. With practice, you learn to let the thoughts and feelings come and go the way you breathe in and out, without being judgmental of yourself, for instance, if you’re feeling guilty or helpless or angry. In practical terms, this helps clear your mind so you can make better choices when dealing with people and situations.
This year, Connelly and her colleague, Sam Green, a U.Va. cell biologist who teaches anatomy and histology, decided they would try to give medical students a taste of what mindfulness meditation could add to their lives, both personally and professionally.
In an intensive, two-week elective for fourth-year medical students during the fall, Connelly and Green introduced a handful of the students to several ways of practicing mindfulness meditation, such as sitting, walking and doing yoga, and integrating these practices into daily life. The course, “Mindful Life/Mindful Practice,” was offered by the Humanities in Medicine program, which Connelly co-directs, and supported by the Mindfulness Center.
Connelly also teaches a more standard, eight-week session in mindfulness-based stress reduction as an instructor at the Mindfulness Center, where doctors Goodman and John Schorling, another Department of Internal Medicine physician, also teach. Goodman and Schorling are offering the eight-week course to physicians and nurse practitioners for the second time this academic year. The classes have received enthusiastic and heartfelt responses from participants.
“Throughout my fourth-year electives [in medical school], I began to see the great need for meditation and mindfulness as ways to manage stress, increase personal awareness, and really deepen and strengthen my connection to medicine and to patients,” said David Hall, who first learned about meditation in a college course on Buddhism. He jumped at the chance to take the mindfulness elective.
Hall and the other students felt that a two-week period was not enough for the course, however, so Connelly and Green are working on making it a four-week elective, similar to other electives fourth-year medical students can take.
Beth Jaeger-Landis, a nurse practitioner with University Medical Associates, where Goodman and Schorling also see patients, asked if she could join their mindfulness class for physicians. She was finding it hard to unwind after work and be relaxed with her family, she said. “I don’t feel burned out, but I’m working with extremely needy patients, and I want to help them. It’s like you wear their burdens, and it’s hard to change modes.”
During a busy clinic day, “sometimes all you’re doing is reacting to one thing after another,” she said, adding that it’s easy to feel like you’re just falling behind. Mindfulness helps her accept her feelings, let them go and move on. She didn’t expect to learn compassion for herself, as well as for her patients, in the class, she said.
The U.Va. medical faculty teaching mindfulness have taken workshops from Jon Kabat-Zinn. Well known for books such as “Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness” and his latest, “Coming to Our Senses: Healing Ourselves and Our World Through Mindfulness,” he visited U.Va. several years ago through the Humanities in Medicine program and the Mindfulness Center.
Health care professionals and medical students aren’t the only ones who can take mindfulness courses. The eight-week sessions are open to anyone at a current fee of $325. For details, contact the center at 924-1190 or http://www.uvamindfulnesscenter.org.
U.Va. employees may use their flexible medical spending accounts to pay or the courses with a doctor’s referral. Check with FlexAmerica at 301-530-9400.